Exacerbation of Alopecia Areata During Pegylated Interferon Alpha-2b and Ribavirin Therapy, Possibly Due to the Collapse of Hair Follicle Immune Privilege
September 2014
in “
European Journal of Dermatology
”
alopecia areata alopecia totalis pegylated interferon alpha-2b ribavirin hair follicle immune privilege SALT score MHC class I molecules HLA-DR-positive CD4+ T cells HLA-DR-positive CD8+ T cells IFN-alpha chronic hepatitis C AA PEG-IFN alpha-2b immune privilege SALT MHC I HLA-DR CD4+ T cells CD8+ T cells interferon alpha hepatitis C
TLDR A woman's hair loss worsened after starting hepatitis C treatment due to immune changes in her hair follicles.
The document reported on a 29-year-old woman with alopecia areata (AA) who experienced a worsening of her condition to alopecia totalis after starting treatment with pegylated interferon alpha-2b (PEG-IFN alpha-2b) and ribavirin for hepatitis C. Her SALT score increased from 23 to 100 following the treatment. Analysis indicated a loss of hair follicle immune privilege, shown by lymphocyte accumulation and increased MHC class I molecules around hair follicles, as well as a rise in HLA-DR-positive CD4+ and CD8+ T cells. The treatment was halted, and hair regrowth was observed two months later. The study suggested that IFN-alpha may induce AA by disrupting hair follicle immune privilege and noted a higher incidence of AA in patients with chronic hepatitis C on combination therapy compared to the general population. No financial support or conflicts of interest were disclosed in the study.
